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Lamictal vs Abilify
Introduction
For patients with bipolar disorder or schizophrenia, certain drugs that influence the chemical balance in the brain can stabilize mood fluctuations and manage symptoms. Lamictal and Abilify are two such medications commonly prescribed for these conditions. Both of them work by modulating various neurotransmitters in the brain, which then aids in stabilizing mood swings experienced by patients with bipolar disorder or schizophrenia.
Lamictal, also known as lamotrigine, is classified as a sodium channel blocker that works by reducing excessive electrical activity in the brain to maintain a balanced mood. On the other hand, Abilify (aripiprazole) operates differently: it's an atypical antipsychotic and dopamine partial agonist that primarily affects levels of dopamine and serotonin. This means it both enhances and reduces dopamine activity where needed to help maintain equilibrium within the brain's complex neurochemical system.
Lamictal vs Abilify Side By Side
| Attribute | Lamictal | Abilify |
|---|---|---|
| Brand Name | Lamictal | Abilify |
| Contraindications | Cannot be taken with certain antifungal medicines, antibiotics like rifampicin, or St John's wort. | Cannot be taken with certain antifungal medicines, antibiotics like rifampicin, or St John's wort. |
| Cost | For brand name: around $600 for 60 tablets of 100 mg. For generic (lamotrigine): between $0.28 to $1 per day for 100 mg/day dosage. | For brand name: about $750 for 30 tablets of 5mg. For generic (aripiprazole): starts as low as about $.35/day up to roughly $3.50/per day. |
| Generic Name | Lamotrigine | Aripiprazole |
| Most Serious Side Effect | Serious skin rashes (Stevens-Johnson syndrome) | Increased thoughts about suicide or self-harm, neuroleptic malignant syndrome, tardive dyskinesia |
| Severe Drug Interactions | Requires a washout period to prevent harmful interactions with certain antifungal medicines, antibiotics, or St John's wort. | Requires a washout period to prevent harmful interactions with certain antifungal medicines, antibiotics, or St John's wort. |
| Typical Dose | Starts at 25 mg/day, gradually increased to a therapeutic dosage range of 100–200 mg/day. Maximum dosage should not exceed 300-400mg/day. | Starts at 10-15 mg per day for adults, can be increased to up to 30 mg/day. For major depressive disorder, starts at 2-5 mg per day added onto an antidepressant, up to 15 mg per day. |
What is Lamictal?
Lamotrigine (the generic name for Lamictal) is a mood stabilizer that was first approved by the FDA in 1994. It interferes with electrical activity in the brain to prevent episodes of mania and depression associated with bipolar disorder, as well as seizures in people with epilepsy. Its exact mechanism is not fully understood but it's believed to inhibit voltage-sensitive sodium channels which suppresses the release of glutamate and aspartate.
Aripiprazole (Abilify), on the other hand, belongs to a class of drugs known as atypical antipsychotics. Approved by the FDA in 2002, Abilify works primarily by modifying dopamine and serotonin levels—two neurotransmitters closely linked to mood disorders—in the brain.
Both medications are used for treating bipolar disorder but their mechanisms are different; while Lamictal acts more like an antidepressant preventing depressive episodes, Abilify can help control symptoms both during manic or mixed episodes due to its antipsychotic properties. Side effects may vary between each medication based on these different actions on neurotransmitters.
What conditions is Lamictal approved to treat?
Lamictal is approved for the treatment of various types of bipolar disorder:
- Maintenance treatment in adults with bipolar 1 disorder to delay the time to occurrence of mood episodes (depression, mania, hypomania, mixed episodes)
- Treatment of acute mood episodes in patients under age 18
- Seizure disorders such as Lennox-Gastaut syndrome and primary generalized tonic-clonic seizures
Abilify has approval for treating different psychiatric conditions:
- Schizophrenia
- Bipolar I Disorder, both Manic or Mixed Episodes
- Adjunctive therapy to antidepressants for Major Depressive Disorder (MDD)
- Irritability associated with autistic disorder
How does Lamictal help with these illnesses?
Lamictal, or lamotrigine, is a medication primarily used to treat epilepsy and bipolar disorder by stabilizing electrical activity within the brain. It does this by inhibiting sodium channels, which reduces the release of glutamate—an excitatory neurotransmitter that can cause seizures when present in excessive amounts. By lowering levels of glutamate, Lamictal can help manage symptoms of both epilepsy and bipolar disorder.
On the other hand, Abilify (aripiprazole) works somewhat differently as it’s an atypical antipsychotic that adjusts levels of dopamine and serotonin—two neurotransmitters that play key roles in mood regulation—in the brain. More specifically, it acts as a partial agonist to dopamine D2 receptors and serotonin 5-HT1A receptors while also serving as an antagonist for serotonin 5-HT2A receptors. This unique "dopamine-serotonin activity modulator" mechanism helps balance these two crucial neurotransmitters without drastically reducing or increasing their overall presence in the brain.
Hence, while both drugs are utilized for managing mental health disorders like bipolar depression--their mechanisms vary significantly due to their different impacts on various neurological pathways.
What is Abilify?
Abilify, a brand name for Aripiprazole, is an atypical antipsychotic and antidepressant used in the treatment of schizophrenia, bipolar disorder, and alongside other medications to treat depression. It works by helping restore the balance of certain natural chemicals in the brain (neurotransmitters) such as dopamine and serotonin. Abilify was first approved by the FDA in 2002. Unlike Lamictal which is not an antipsychotic medication but rather an anti-epileptic or anticonvulsant drug primarily used to treat seizures associated with epilepsy in adults and children aged two years old and above. Abilify's action on dopamine means that its side-effect profile differs from that of drugs like Lamictal; it does not typically produce significant sedation or weight gain -- common side effects of many antipsychotics. However, it can cause some sexual dysfunction similar to SSRIs like Prozac due to its influence on serotonin levels. The unique impact Abilify has on both dopamine and serotonin neurotransmitters makes it particularly effective for patients who have not responded well to traditional treatments.
What conditions is Abilify approved to treat?
Abilify, also known as aripiprazole, is an antipsychotic medication that has received FDA approval for the treatment of several serious mental health conditions. These include:
- Schizophrenia
- Bipolar disorder
- Major depressive disorder (in combination with antidepressants) It's also used in treating irritability associated with autism in pediatric patients.
How does Abilify help with these illnesses?
Dopamine is a neurotransmitter that plays vital roles in our brain's reward system, mood regulation, and motor functions. Like norepinephrine, imbalances or disruptions in dopamine levels can contribute to mental health conditions like depression and bipolar disorder. Abilify works by stabilizing the dopamine levels in the brain through partial agonist activity at D2 receptors, thereby helping to alleviate symptoms of these conditions. Its action on serotonin receptors also helps regulate mood. Unlike Lamictal which primarily acts on voltage-gated sodium channels to stabilize mood, Abilify has a broader spectrum of action and may be preferred when patients do not respond well to other treatments or require additional symptom management for comorbid conditions such as schizophrenia.
How effective are both Lamictal and Abilify?
Lamotrigine (Lamictal) and aripiprazole (Abilify) both have established track records in treating bipolar disorder, with their initial FDA approvals being only 5 years apart. They act on different areas of the brain, hence they may be prescribed under diverse circumstances. The effectiveness of Lamictal and Abilify was compared in several clinical trials where both drugs showed similar efficacy in managing bipolar symptoms as well as comparable safety profiles.
A 2004 meta-analysis review demonstrated that Lamictal is effective at preventing mood episodes from the first week of treatment, has a favourable side effect profile over many other mood stabilizers, and it’s well-tolerated even by elderly patients. This study also reports that Lamictal has become one of the most widely-prescribed mood stabilizer globally due to its minimal side effects profile.
A 2016 review indicated that Abilify seems to be more effective than placebo for keeping patients with bipolar disorder symptom-free for longer periods, suggesting it's equally efficient as other common treatments for this condition. However, Abilify is often considered after or alongside other first-line treatments such as lithium or valproate. Though research confirms its efficacy as a standalone treatment is robust like lamotrigine's; data supporting Abilify significantly augmenting the effect of these mainstays are still generally lacking. Despite this caveat, thanks to its unique pharmacology involving partial dopamine receptor agonism among others - Aripiprazole may serve optimally those who didn’t respond adequately to conventional treatments or need avoidance from certain adverse effects associated with them – like notable weight gain etc.
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At what dose is Lamictal typically prescribed?
Oral dosages of Lamictal for adults typically start at 25 mg/day and may be gradually increased by 25-50 mg every one to two weeks. For most people with bipolar disorder, the therapeutic dosage range is between 100–200 mg/day. Children's doses are usually determined based on weight, starting at a lower dose that can be gradually increased over several weeks if needed. In any case, the maximum dosage should not exceed 300-400mg/day depending on individual patient response and tolerance level.
In comparison, oral dosages of Abilify for adults typically begin at 10 or 15 mg once daily and may be increased up to a maximum of 30 mg per day if necessary. Pediatric patients aged from ten to seventeen years old generally start at a lower dose (2mg), which can also be adjusted if required after a few weeks.
At what dose is Abilify typically prescribed?
Abilify treatment typically begins at a dosage of 10-15 mg per day for adults with schizophrenia and bipolar disorder. The dose can be increased to up to 30 mg/day, taken as a single daily dose. For major depressive disorder, the usual starting dose is 2-5 mg per day added onto an antidepressant, which can then be adjusted up to 15 mg per day if required. Children's dosages will vary based on age and condition being treated so always consult your healthcare provider for appropriate dosing. Always remember that adjustments should occur gradually under the supervision of your healthcare professional since each individual responds differently to medication; some people may not see improvements until after several weeks of therapy.
What are the most common side effects for Lamictal?
Some common side effects of Lamictal (lamotrigine) can include:
- Dizziness
- Headache
- Double vision or other changes in vision
- Nausea and vomiting
- Rash, itchy skin
- Sleepiness/drowsiness (somnolence)
- Unsteady walking and coordination difficulties -Tremors
On the other hand, Abilify (aripiprazole) has its own set of potential side effects such as:
-Anxiety
-Restlessness or feeling jittery
-Difficulty sleeping (insomnia)
-Nervousness,
-Somnolence,
-Increased salivation
-Asthenia,
-Nausea,
-Vomiting, constipation
-Lightheadedness or fainting when standing quickly from a sitting position
Both medications have their unique sets of side effects. Remember that not everyone experiences all listed side effects and some may experience none at all. Always consult with your healthcare provider to discuss any concerns about medication-related symptoms.
Are there any potential serious side effects for Lamictal?
While both Lamictal and Abilify are used to treat mood disorders, they do have different side effects. With Lamictal, patients must be vigilant for signs of serious skin rashes (Stevens-Johnson syndrome), which include fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads and causes blistering and peeling.
With Abilify on the other hand, possible severe side effects may include increased thoughts about suicide or self-harm especially among those under 24 years old; symptoms of an allergic reaction such as hives, difficult breathing; rapid heartbeats; dizziness due to sudden drop in blood pressure when standing up from sitting/lying position. Some people might experience neuroleptic malignant syndrome - a life-threatening nervous system problem with high fever; sweating; fast heartbeat leading to fainting spells.
Other potential issues could involve low sodium levels causing headache confusion slurred speech severe weakness vomiting loss of coordination feeling unsteady. Any symptoms suggestive of serotonin syndrome: agitation hallucinations fever sweating shivering fast heart rate muscle stiffness twitching loss of coordination nausea vomiting diarrhea should also merit immediate medical attention.
What are the most common side effects for Abilify?
The side effects of Abilify are not to be taken lightly and can include:
- Dry mouth, sore throat
- Blurred vision
- Nausea, upset stomach, constipation
- Sleep problems such as insomnia or excessive sleepiness
- Weight gain rather than weight loss is more common with Abilify. It's important to monitor this closely due to the risk of diabetes.
- Anxiety or restlessness rather than agitation or hostility
- Headache, dizziness could occur.
- Muscle stiffness or spasms may happen instead of joint pain.
It's also essential to note that Abilify might cause increased urination and sweating in some patients. Always discuss potential side effects with your healthcare provider before starting a new medication.
Are there any potential serious side effects for Abilify?
While Abilify is a commonly prescribed medication for various mental health conditions, it's important to be aware of the potential side effects. Watch out for these severe symptoms:
- Signs of an allergic reaction like hives, itching, fever, swollen glands or unexplained rash
- Difficulty breathing and pronounced swelling in your face or throat
- Sudden confusion or unusual changes in behavior
- Vision disturbances such as blurred vision, eye pain or swelling and seeing halos around lights
- Uncontrollable movements of your body parts (known as tardive dyskinesia)
- Seizures (convulsions)
- Increased heart rate that may feel irregular; this could lead to dizziness and fainting spells.
In addition to the physical symptoms above, seek immediate medical help if you experience increased suicidal thoughts. Also watch out for signs of a manic episode - racing thoughts, extreme happiness or irritability without reason, reckless behaviors - all while talking more than usual and having serious problems with sleep. If any of these occur while taking Abilify, consult with your healthcare provider immediately.
Contraindications for Lamictal and Abilify?
Both Lamictal and Abilify, as with many psychiatric medications, may intensify symptoms of depression in some individuals. If you observe a worsening in your mood or an increase in suicidal thoughts or behaviors, it is crucial to seek immediate medical assistance.
Neither Lamictal nor Abilify can be taken if you are consuming other specific types of drugs such as certain antifungal medicines (like ketoconazole), antibiotics (such as rifampicin) or St John's wort - a common herbal treatment for depression. Always keep your healthcare provider informed about all the medications you are taking; these will require a washout period to clear from the system to prevent harmful interactions with both Lamictal and Abilify.
How much do Lamictal and Abilify cost?
For the brand name versions of these drugs:
- The price of 60 tablets of Lamictal (100 mg) averages around $600, which works out to $20–40/day, depending on your dose.
- The price for 30 tablets of Abilify (5mg) is about $750, working out to approximately $25/day.
Thus, if you are in the higher dosage range for Lamictal (i.e., 200 mg/day or higher), then brand-name Abilify is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.
For the generic versions - lamotrigine and aripiprazole respectively - costs are significantly lower:
- Lamotrigine (100 mg tablets) is available in packs from 30 capsules and above, with approximate costs between $0.28 to $1 per day for dosages of 100 mg/day or around $.56 to $2 per day if taking more typical dosages up to 200 mg/day.
- Aripiprazole is available in packs ranging from15 up to several hundred capsules at doses starting at 5mg, with the cost starting as low as about $.35/day if buying larger quantities upfront and not exceeding roughly $3.50/per day.
Popularity of Lamictal and Abilify
Lamotrigine, also known by the brand name Lamictal, was estimated to have been prescribed to about 4.5 million people in the US in 2020. It is not only used as an anticonvulsant medication for epilepsy but has a significant role as a mood stabilizer in bipolar disorder treatment. In recent years, its use has generally increased due to its effectiveness and tolerability.
Aripiprazole, available under the brand name Abilify among others, was prescribed to approximately 7 million individuals in the USA during that same year. This atypical antipsychotic is commonly used for treating schizophrenia and bipolar disorder but can be adjunctive therapy for major depressive disorders too. In terms of prescriptions written relative to other atypical antipsychotics within America's healthcare system over this period, it stood at roughly 15%. The prevalence of Aripiprazole has seen steady growth since it entered medical usage nearly two decades ago.
Conclusion
Both Lamictal (lamotrigine) and Abilify (aripiprazole) have substantial histories of use in managing mental health disorders, particularly bipolar disorder. They are supported by multiple clinical trials and meta-analyses indicating their effectiveness compared to placebo treatments. In certain situations, these medications may be used together under the careful supervision of a healthcare provider as they can interact with each other. Due to their unique mechanisms of action—with lamotrigine primarily stabilizing mood by inhibiting voltage-sensitive sodium channels, and aripiprazole acting mainly as a partial agonist at dopamine D2 and serotonin 5-HT1A receptors—they tend to be prescribed for different circumstances.
Lamictal is often considered first-line treatment for bipolar depression while Abilify is regularly employed as an add-on therapy or in patients who do not respond well to conventional mood stabilizers or need help managing manic symptoms.
Generics for both medications are available which can significantly reduce costs especially for those not covered by insurance. It's worth noting that both Lamictal and Abilify might require an adjustment period before beneficial effects become apparent.
The side effect profile between the two drugs exhibits similarities, yet they're generally well-tolerated; however, Lamictal has less tendency towards weight gain than Abilify does. Patients must closely monitor their moods when starting either medication and should seek immediate medical attention if they notice worsening depressive or manic symptoms or begin having suicidal thoughts.
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Refrences
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